When pure, the acid consists of short, colorless, prismatic, needle-like crystals, which have a burning sweetish taste, which turn pink and liquefy when exposed to air.

It has a characteristic 'carbolic' or phenolic smell.

 

The commercial carbolic acid is a dark-brown liquid containing several impurities, chiefly cresol.

It is largely used as an antiseptic and as a disinfectant in various preparations.

Example: Lysol, Dettol

 

Fatal Dose: 10 to 15 gm (gram because solid/crystals)

Fatal Period: Three to four hours

Poisoning by carbolic acid is known as carbolism.

Excretion:

Phenol is converted into hydroquinone and pyrocatechol in the body before being excreted in the urine. A trace is excreted by the lungs, salivary glands, skin, and stomach. About 36 hours are required for complete excretion. It is partly detoxicated by the liver.

 

Signs and Symptoms of Carbolic Poisoning: (Ref Reddy)

Local:

1) Skin: It causes burning and numbness due to damage to nerve endings. There may be necrosis and gangrene of the tissue which becomes green-white or brown-white; the dead tissue sloughs readily. It precipitates protein and coagulates the cell contents and tends to stiffen the tissues and bleach them, so that hard, cracked, whitish surfaces are seen on the face and skin.

2) Digestive Tract: The lips, mouth, and tongue are corroded, which soon become white and hardened. Hot burning pain extends from the mouth to the stomach, which is followed by tingling and later anesthesia. Deglutition and speech become painful and difficult.

3) Respiratory Tract: Pulmonary and laryngeal edema develop due to irritation. When vomiting occurs, the poison may be aspirated into the lungs, causing bronchitis and bronchopneumonia.

 

Systemic Effects:

 

Urine:

It is scanty and contains albumin and free hemoglobin; suppression may follow. It may be colorless or slightly green at first but turns green or even black on exposure to air. The further oxidation of hydroquinone and pyrocatechol in the urine is the cause of green coloration. This is known as carboluria.

In the body, phenol is partly oxidized to hydroquinone and pyrocatechol, which with unchanged phenol are excreted in the urine, partly free, and partly in unstable combination with sulphuric and glucuronic acids.

 

Carboluria:

After carbolic acid poisoning, urine is suppressed or scanty and urine may be normal or slightly green at first, but turns green or even black on exposure to air. This symptom is called carboluria.

 

CHRONIC POISONING (PHENOL MARASMUS)

It is characterized by anorexia, weight loss, headache, vertigo, dark urine, and pigmentation of skin and sclera. Hydroquinone and pyrocatechol may cause pigmentation in the cornea and various cartilages, a condition called ochronosis.

 

 

Treatment of Carbolic Acid Poisoning: (Ref Reddy)

1) An emetic often fails due to the anesthetic effect.

2) The stomach should be washed repeatedly, carefully with plenty of lukewarm water containing activated charcoal, olive oil, castor oil, magnesium, or sodium sulphate with which phenol combines and forms harmless products.

Soap solution or 10% glycerine may be used and the washing continued until the washings are clear and odorless. This is followed by the administration of olive oil or vegetable oil to remove surface phenol and prevent deep penetration.

3) When lavage is completed, 30 g. of magnesium sulphate or a quantity of medicinal liquid paraffin should be left in the stomach.

4) Demulcents

5) Saline containing 7gm of sodium bicarbonate per liter is given i.v. to combat circulatory depression, to dilute carbolic acid content of blood and to encourage excretion by producing diuresis.

6) Hemodialysis, if there is renal failure.

7) Methylene blue i.v., if there is severe methemoglobinemia.

8) If phenol falls on the body, contaminated clothing should be removed at once, skin washed with undiluted polyethylene glycol. If this is not available the area is washed with soap and water for at least 15 minutes. Olive oil, or methylated spirit, or ten percent solution of ethyl alcohol act as solvents.

 

Treatment of Carbolic Acid Poisoning

A. When fall on the body

Contaminated cloth should be removed at once.

Skin surface should be thoroughly washed with soap & water.

 

B. When ingested

1) An emetic often fails due to the anesthetic effect.

2. Stomach wash with plenty of lukewarm water containing magnesium or sodium sulphate is used OR soap solution or 10% glycerine in water until washing are clear and odorless.

3) When lavage is completed, 30 g. of magnesium sulphate or a quantity of medicinal liquid paraffin should be left in the stomach.

4) Demulcents

5) Saline containing 7gm of sodium bicarbonate per liter is given i.v. to combat circulatory depression, to dilute carbolic acid content of blood and to encourage excretion by producing diuresis.

6) Hemodialysis, if there is renal failure.

 

Postmortem Appearances of Carbolic Acid:

External:

Corrosion of the skin, especially in tracks from the angles of the mouth on to chin, has a grayish or brown color.

The tongue is usually white and swollen, and there is a smell of phenol in the mouth.

The mucous membrane of the lips, mouth, and throat is corrugated, sodden, whitened, or ash-grey and partially detached with numerous small sub-mucous hemorrhages.

 

Internal:

The mucosa of the esophagus is tough, white or grey, corrugated.

The stomach mucosal folds are swollen and covered by opaque, coagulated, grey or brown mucous membrane.

The stomach may contain a reddish fluid mixed with mucus and shreds of epithelium and smells of phenol.

The liver and spleen usually show a whitish, hardened patch where the stomach has been in contact with them due to the transudation of phenol.

If vomit or poison has been inhaled, coagulation necrosis of the mucosa and severe congestion of the submucosa of the air passages may be seen. Laryngeal and pulmonary edema also occur.

The kidneys show hemorrhagic nephritis in cases of delayed death.

The brain is congested, maybe edematous.

The blood is dark and semifluid or only partially coagulated.

 

Cause of Death:

1) Syncope

2) Asphyxia due to

  (a) failure of respiration,

  (b) edema of glottis,

  (c) complications, e.g.bronchopneumonia.

 

Circumstances of Poisoning:

1) It is used for suicidal purposes.

2) Accidental poisoning.

3) It is rarely used for homicide because of its odor and taste. 4) It is sometimes injected into the vagina and uterus to produce abortion.

5) Its indiscriminate medical use sometimes causes poisoning.

 

Meaning

Corroded: Destroy or weaken (something) gradually. Like a rusting appearance.